Fear of Botox
By Jim Rue
Botox is a nerve toxin created by Clostridium botulinum bacteria, aka botulism. Botulism is a poison, the deadliest poison on the planet. This is scary.
There are several forms of botulism. Wound botulism is rare. It occurs when Clostridium botulinum gets into the bloodstream through a wound or break in the skin. A variety of heroin called black tar can harbor the spore, and when injected, can cause infection.
Food-borne botulism accounts for 25% of cases of botulism poisoning. It comes from eating infected food, very often home-canned food that was improperly prepared.
Infant botulism, the most common botulism poisoning, accounts for 75% of American cases. It is thought that the stomach of an infant does not have the micro flora or acids necessary to quell the growth of Clostridium botulinum and there fore creates an ideal medium for growth of the microorganism. The intake of sweeteners such as corn syrup, sugar or especially honey before weaning is the usual cause of infant botulism. Unfortunately, the fatality rate for this variety of botulism poisoning, colloquially known as 'floppy baby syndrome,' stands at about 10% of reported cases, mostly because of delays in an accurate diagnosis until too late.
Now the Good News
First of all, botulism is killed by contact with air or heat. Boiling infected foods does the trick. But more important, public fears about botulism poisoning in the U.S. are excessive compared to the actuality. According to a 2003 Harvard study, public perception is that there are from 100 to 3000 fatalities due to botulism each year. The actual number of annual fatalities: 2. (pdf)
The toxin has been used for some years in the treatment of chronic headaches and upper back and neck pain, and more recently to control sweaty hands and armpits. It has also been shown useful in controlling spastic muscle activity in stroke patients, fluttering eyelids, strabismus (misaligned eyeballs), voice tremors, and in helping to control overactive bladders.
And the Big Show
But the big news of the decade for plastic surgeons is Botox, or botulinum toxin type A. About a week after injection, Botox begins to prevent the release from the nerve endings around the effected muscles of a neurotransmitter called acetylcholine. The acetylcholine, if released, would otherwise cause muscles to contract, resulting in wrinkles. Used in small amounts to paralyze the muscles of the face, butt or breasts, Botox offers short-term relief (about twelve weeks) from some of the physical effects of aging.
The trade substance Botox, manufactured in Ireland by Allergan, was approved by the FDA in 2002 for use in the U.S. According to the American Society of Plastic Surgeons, the number of Botox injections provided to Americans rose to 2,890,000 in 2003, almost quadruple the number performed in 2000. To be fair, the 2003 number counts each separate anatomical site as a separate procedure, departing from past statistics, but even the 2002 figures show a 50% rise from 2000. A nearly identical product but for the dosages dispensed, Dysport, is manufactured and sold in England.
